ABSTRACT
A 26-year-old man presented to the emergency department with chest tightness and shortness of breath. He had noticed that he was becoming increasingly dyspnoeic over the preceding 3–4 weeks and was now short of breath on minimal exertion. He described his chest as feeling tight but denied pain. He had a non-productive cough and said that he had noticed a wheeze when he was particularly breathless. He denied any past medical history and took no regular medications. He worked as a cleaner in a local sauna. The patient had been born in the United Kingdom and had no known tuberculosis contacts. He lived with his brother and had one regular female sexual partner. He had never smoked tobacco. He drank around 30 units of alcohol per week and used ecstasy on weekends. He had travelled to Ibiza 2 months earlier.
